Author Interviews, Blood Pressure - Hypertension, Cognitive Issues / 05.04.2022

MedicalResearch.com Interview with: Dr. Yangfeng Wu Peking University Clinical Research Institute Peking University MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: It is well-established that elevated blood pressure (BP) at single time point can contribute to increased risks of suffering accelerated cognitive decline, dementia, and mortality. Nevertheless, BP levels could experience significant alterations as time goes, indicating the necessity of monitoring BP longitudinally. In other words, using blood pressure levels measured at baseline to predict future outcomes in a longitudinal cohort with a long-term follow-up period ≥20 years, becomes controversial. Cumulative BP levels have been indicated as a feasible approach for evaluating long-term exposure of BP levels, which might have the ability to respond to this controversy. This is the main reason why we performed this research to evaluate the predictive values of cumulative BP levels, especially additional values beyond baseline blood pressure levels, for future neurocognitive and longevity outcomes. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension / 18.03.2022

MedicalResearch.com Interview with: Paolo Palatini, M.D. Professor of Internal Medicine University of Padova Padova, Italy  MedicalResearch.com:  What is the background for this study?  Response: Up to now doctors measured blood pressure (BP) on standing only in elderly people on pharmacological treatment with the purpose of detecting orthostatic hypotension. In young-to-middle-age people BP is currently measured only in the lying or the sitting posture. Our starting point was that young borderline hypertensive people have an increased sympathetic activity and thus they might be hyperreactive to physical stimuli such as assuming the orthostatic posture which may be deleterious in the long run. This hypothesis was tested in the HARVEST, a study initiated in Italy in 1990, in which over 1200 young patients screened for stage 1 hypertension were enrolled. (more…)
Author Interviews, Blood Pressure - Hypertension, Cognitive Issues, NIH / 12.03.2022

MedicalResearch.com Interview with: Lenore J. Launer, Ph.D. Chief, Laboratory of Epidemiology and Population Sciences Intramural Research Program, National Institute on Aging. MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Identifying early risk factors and early changes in the brain will have a major impact on future clinical and public health priorities related to the looming epidemic of dementia. Several studies based on older populations suggest mid-life is an important period to start prevention measures. To date control of blood pressure levels has been the most robust and promising candidate to target for prevention of future cognitive impairment. Although several studies have looked at levels of blood pressure and risk for cognitive impairment, it was not known whether trajectories from young adulthood to middle age studies provided additional information about risk. To investigate possible biomarkers of future risk, we chose to examine the association of the mean arterial blood pressure trajectories to indicators of pathology seen on MRI and that are associated with cognition. We highlight the results of the mean arterial blood pressure (MAP) measure, which is an integrated measure of systolic and diastolic blood pressure. (more…)
AHA Journals, Blood Pressure - Hypertension, Dental Research, Menopause / 07.03.2022

MedicalResearch.com Interview with: Michael J. LaMonte, PhD, MPH Research Professor (epidemiology) Department of Epidemiology and Environmental Health School of Public Health and Health Professions Women’s Health Initiative Northeast Regional Center University at Buffalo – SUNY Buffalo, NY 14214 MedicalResearch.com:  What is the background for this study?  What are the main findings? Dr. LaMonte:  The rationale for this study was based on existing study results showing
  • (1) oral bacteria are involved with conversion of dietary nitrate (e.g., from leafy greens and beets) to nitric oxide which is a chemical involved keeping arteries healthy and maintaining blood pressure;
  • (2) rinsing the mouth with antiseptic solution (mouthwash) kills oral bacteria and results in rapid increases in systolic and diastolic blood pressure; and
  • (3) a very limited amount of epidemiological data suggest that the oral bacteria found beneath the gums (responsible for gingivitis and periodontal disease) are associated with blood pressure and history of hypertension in middle-aged adults.
Thus, we conducted our study to determine whether oral bacteria (beneath the gums) would be predictive of developing hypertension among women who were without this condition at the time the bacteria were measured. Because the bacteria (exposure) would be known to precede development of hypertension (disease), an association seen in our study would be strongly suggestive of a role for oral bacteria in the development of high blood pressure. Our primary result was for statistically significant higher risks of developing hypertension associated with 10 bacterial species, and significantly lower risks of developing hypertension associated with 5 bacterial species. Our findings were evident even after we accounted for differences in demographic factors, lifestyle factors, and clinical factors, and generally were of consistent magnitudes we examined across subgroups of older and younger women, white and black women, normal weight and overweight/obese women, those with normal or slightly elevated blood pressure at study enrollment, and those who were using or not using menopausal hormone therapy at baseline. Therefore, while our observational study evidence for an association is not equivalent to causation, the robustness of the associations between oral bacteria and hypertension risk supports a need to further understand this relationship, ideally with a clinical trial design that would provide definitive evidence to support or refute causation.  (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Race/Ethnic Diversity, Social Issues / 03.02.2022

MedicalResearch.com Interview with: Xing Gao, MPH, lead author and doctoral candidate in Dr. Mujahid's research group Mahasin Mujahid, MS, PhD, FAHA Lillian E. I. and Dudley J. Aldous Chair in the School of Public Health Associate Professor of Epidemiology Director, Epidemiology & Biostatistics Master of Public Health Program UC Berkeley, School of Public Health MedicalResearch.com:  What is the background for this study?  What are the main findings?
  • ​​Hypertension is a major risk factor for cardiovascular diseases, and persistent racial and ethnic inequities in hypertension remain an urgent public health challenge.
  • Public health researchers need a more nuanced understanding of how structural factors contribute to these inequities, which has a direct application to improving the cardiovascular health of marginalized populations.
  • This study examined associations between racial residential segregation, a product of historical and contemporary racially discriminatory policies, and hypertension in a multi-racial cohort of middle-aged and older adults. 
(more…)
Aging, Alzheimer's - Dementia, Author Interviews, Blood Pressure - Hypertension, JAMA / 14.12.2021

MedicalResearch.com Interview with: Jan Willem van Dalen, PhD Department of Neurology Donders Institute for Brain, Behaviour and Cognition Radboud University Medical Centre Nijmegen Department of Neurology The Netherlands3Department of Public and Occupational Health Amsterdam UMC, University of Amsterdam, Amsterdam   MedicalResearch.com: What is the background for this study? Response: Although high systolic blood pressure in midlife has consistently been reported as a condition that increases the risk of developing dementia in old age, reports regarding this relationship in older people have been inconsistent. One potential reason for this, is that the relationship between systolic blood pressure and dementia in later life may be U-shaped, meaning that both individuals with low and with high systolic blood pressure are at increased incident dementia risk. This study combined data from several longitudinal cohort studies specifically designed to study incident dementia in older people, to investigate whether these U-shaped relationships exist, and in which age ranges they appear. We included more than 16,500 people aged 60 and older, with over 2,700 incident dementia cases. Also, we aimed to investigate whether these observational associations might be caused by confounding, differences in mortality, or result from opposite relationships between certain subgroups of individuals. (more…)
Author Interviews, Blood Pressure - Hypertension, Exercise - Fitness, Heart Disease, JAMA / 05.08.2021

MedicalResearch.com Interview with: Fernando Ribeiro PhD School of Health Sciences Institute of Biomedicine - iBiMED University of Aveiro Aveiro, Portugal MedicalResearch.com: What is the background for this study? What are the main findings? Response: Resistant hypertension is a puzzling problem without a clear solution. The available treatment options to lower blood pressure, namely medication and renal denervation, have had limited success, making nonpharmacological strategies good candidates to optimize the treatment of this condition. Exercise training is consistently recommended as adjuvant therapy for patients with hypertension, yet, it is with a great delay that the efficacy of exercise training is being tested in patients with resistant hypertension. Having that in mind, the EnRicH trial was designed to address whether the benefits of an exercise intervention with proven results in hypertensive individuals are extended to patients with resistant hypertension, a clinical population with low responsiveness to drug therapy. Exercise training was safe and associated with a significant and clinically relevant reduction in 24-hour, daytime ambulatory, and office blood pressure compared with control (usual care). (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Kidney Disease / 04.08.2021

MedicalResearch.com Interview with: Maria Luisa S. Sequeira Lopez, MD, FAHA Harrison Distinguished Professor in Pediatrics and Biology University of Virginia Charlottesville, VA 22908 MedicalResearch.com: What is the background for this study? Response: The renin-angiotensin system (RAS) is crucial in the regulation of the blood pressure (BP). Synthesis and secretion of renin is the key regulated event in the operation of the RAS. One of the main mechanisms that control renin synthesis and release is the baroreceptor mechanism whereby a decrease in blood pressure results in increased release of renin by juxtaglomerular (JG) cells. In spite of its enormous importance, the nature and location of the renal baroreceptor was still unknown. This was due in great part to the lack of appropriate in vitro and in vivo models to confidently allow tracking of the fate and isolation of renin cells, and the lack of tools to study the chromatin in scarce cells. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Columbia / 27.07.2021

MedicalResearch.com Interview with: George Hripcsak, MD, MS. Chair and Vivian Beaumont Allen Professor of Biomedical Informatics Department of Biomedical Informatics, Columbia University Irving Medical Center New York, NY MedicalResearch.com: What is the background for this study? Response: ACE inhibitors and ARBs are anti-hypertension drugs that have related yet distinct mechanisms of action, and they are both recommended as first-line therapies for treating hypertension. There have been no large head-to-head comparisons of ACE inhibitors and ARBs, although there are several studies with limited size and often restricted (e.g., high-risk) populations. While there are some conflicting results in the literature, the current evidence seems to indicate that they are similar in effectiveness but that ACE inhibitors have more side effects (e.g., cough and angioedema). (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Cognitive Issues, Memory / 21.06.2021

MedicalResearch.com Interview with: Daniel A. Nation, Ph.D., Associate Professor of Psychological Science Institute for Memory Impairments and Neurological Disorders University of California, Irvin MedicalResearch.com: What is the background for this study? Response: Hypertension is a risk factor for cognitive decline and dementia, and treatment of hypertension has been linked to decreased risk for cognitive impairment. Prior studies have attempted to identify which specific type of antihypertensive treatment conveys the most benefit for cognition, but findings have been mixed regarding this question.  We hypothesized that antihypertensive drugs acting on the brain angiotensin system may convey the greatest benefit since they affect the brain angiotensin system that has been implicated in memory function. (more…)
Author Interviews, Blood Pressure - Hypertension, JAMA, USPSTF / 07.05.2021

MedicalResearch.com Interview with: John B. Wong, M.D. Chief Scientific Officer Vice chair for Clinical Affairs Chief of the Division of Clinical Decision Making and Primary care Clinician Department of Medicine at Tufts Medical Center   MedicalResearch.com: What is the background for this study? Response: Hypertension affects nearly half of all adults in the United States and is a major risk factor for many serious health conditions. Fortunately, by screening all adults for hypertension, clinicians can improve their patient’s health. The Task Force continues to recommend screening all adults for hypertension so that they can get the care they need to help prevent health conditions such as heart attack, stroke, and kidney failure. (more…)
AHA Journals, Author Interviews, Baylor College of Medicine Houston, Blood Pressure - Hypertension, Microbiome / 30.04.2021

MedicalResearch.com Interview with: David J. Durgan, PhD Department of Anesthesiology Baylor College of Medicine Houston, TX  MedicalResearch.com: What is the background for this study? Response: Our lab and others had previously shown that gut dysbiosis is not only associated with hypertension, but actually plays a causal role. For example we have shown in both a genetic model of hypertension as well as an obstructive sleep apnea induced model of hypertension, that transplantation of their dysbiotic microbiota into normotensive recipients induced elevations in blood pressure. With this understanding our focus shifted to two new questions 1) How can we manipulate the microbiota to improve/prevent hypertension, and 2) What are the signals originating from the microbiota that have the capability to influence host blood pressure? These questions lead to the experimental design of this study. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Dental Research / 30.03.2021

MedicalResearch.com Interview with: Francesco D’Aiuto Professor/Hon Consultant Head of Periodontology Unit UCL Eastman Dental Institute  MedicalResearch.com: What is the background for this study? Response: This study was set out to further our understanding of the link between gum disease and high blood pressure. Recent evidence suggested that individuals with gum disease had a 20-70% increased risk of hypertension and systemic inflammation seemed to be a driver in mediating this association. Further research on the matter was needed. We recruited two relatively large groups of otherwise healthy participants (without a confirmed diagnosis of hypertension) who had gum disease one and healthy gums the other. We found that diagnosis of periodontitis (gum disease) was consistently linked to higher systolic blood pressure independent of other cardiovascular risk factors. (more…)
Author Interviews, Blood Pressure - Hypertension, Pediatrics / 12.03.2021

MedicalResearch.com Interview with: Melanie Clark PhD candidate Murdoch Children's Research Institute The Royal Children's Hospital  blood-pressure-children-hypertensionMedicalResearch.com: What is the background for this study? What are the main findings? Response: Hypertension in children is a growing problem around the world, but when diagnosing hypertension, most of the time blood pressure is only measured in one arm. Our study showed that children can have a blood pressure difference between arms that may be considered significant in a clinical setting. One in four children had a difference between left and right arms that could mean that blood pressure appears normal in one arm, but in the other arm it would be classified as a high blood pressure. This means that if a doctor measures blood pressure in one arm only, a diagnosis of high blood pressure could be missed. (more…)
AHA Journals, Author Interviews, Heart Disease, Race/Ethnic Diversity, Stroke / 05.03.2021

MedicalResearch.com Interview with: Fernando D Testai, MD, PhD, FAHA Associate Professor of Neurology and Rehabilitation Stroke Medical Director University of Illinois Health MedicalResearch.com: What is the background for this study? Response: Stroke constitutes a leading cause of disability and mortality in the United States. Large observational studies have shown that up to 90% of the strokes are caused by modifiable vascular risk factors, including hypertension, diabetes mellitus, and several others. In addition, previous history of stroke is one of the most powerful predictors of recurrent stroke. Thus, controlling vascular risk factors in patients with stroke is of paramount importance. To this end, the American Heart Association and the American Stroke Association have developed specific targets for blood pressure, glycemic, and cholesterol levels. (more…)
Author Interviews, Blood Pressure - Hypertension, Kidney Disease / 24.02.2021

MedicalResearch.com Interview with: Dr. FotiKathryn Foti, PhD, MPH Postdoctoral fellow Department of Epidemiology Johns Hopkins Bloomberg School of Public Health MedicalResearch.com: What is the background for this study? Response: The Kidney Disease: Improving Global Outcomes (KDIGO) 2021 Clinical Practice Guideline for the Management of Blood Pressure (BP) in Chronic Kidney Disease (CKD) provides recommendations for the management of BP in individuals with nondialysis CKD, incorporating new evidence since the publication of its previous guideline in 2012. The 2021 KDIGO guideline recommends a target systolic BP <120 mmHg based on standardized office BP measurement. This BP goal is largely informed by the findings of the SPRINT trial which found targeting SBP <120 mmHg compared with <140 mmHg reduced the risk of cardiovascular disease by 25% and all-cause mortality by 27%. The benefits were similar for participants with and without CKD. In our study, we sought to examine the potential implications of the 2021 KDIGO guideline for BP lowering among US adults with CKD compared to the 2012 KDIGO guideline (target BP ≤130/80 mmHg in adults with albuminuria or ≤140/90 mmHg or under without albuminuria) and the 2017 American College of Cardiology/American Heart Association (target BP <130/80 mmHg) guideline. Additionally, we determined implications of the 2021 KDIGO guideline for angiotensin converting enzyme inhibitor (ACEi) or angiotensin II-receptor blocker (ARB) use for those with albuminuria (recommended at systolic BP ≥120 mmHg) compared to the 2012 KDIGO guideline (recommended at BP >130/80 mmHg).  (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Heart Disease / 21.12.2020

MedicalResearch.com Interview with: Chris Clark, PhD Clinical Senior Lecturer in General Practice Primary Care Research Group St Luke's Campus, Exeter MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Various individual studies have suggested that a blood pressure difference between arms is associated with increased mortality and cardiovascular events since we first reported this association in 2002. Such studies have been limited, due to smaller numbers of participants, in the conclusions that could be drawn. Therefore we sought to pool data from as many cohorts as possible to study this association in more detail.  MedicalResearch.com: What are the main findings? Should it be standard practice to measure blood pressure in both arms? Response: Systolic inter-arm difference was associated with increased all-cause and cardiovascular mortality. We found that all-cause mortality increased with inter-arm difference magnitude from a ≥5 mmHg threshold. Systolic inter-arm difference was also associated with cardiovascular events in people without pre-existing disease. This remained significant after adjustment for various internationally used cardiovascular risk scores, namely ASCVD, Framingham or QRISK2. Essentially we found that each increase of 1mmHg in inter-arm difference equated to a 1% increase for a given cardiovascular risk score. When undertaking a cardiovascular assessment, or determining which arm should be used for blood pressure measurement, it is recommended to measure both arms. (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease, Pediatrics, USPSTF / 19.11.2020

MedicalResearch.com Interview with: Martha Kubik, Ph.D., R.N. Professor and director of the School of Nursing College of Health and Human Services at George Mason University USPSTF Task Force Member MedicalResearch.com: What is the background for this study? What are the main findings? Has the recommendation changed over the last decade? Response: High blood pressure is becoming more common among children and teens in the United States and can have serious negative health effects in childhood and adulthood, such as kidney and heart disease. However, there is not enough research to know whether treating high blood pressure in young people improves cardiovascular health in adulthood. The Task Force continued to find that there is not enough evidence to recommend for or against screening for high blood pressure in children and teens who do not have signs or symptoms. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Circadian Rhythm / 05.11.2020

MedicalResearch.com Interview with: Kazuomi Kario, MD, PhD, FACP, FACC, FAHA, FESC, FJCS Professor, Chairman Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine (JMU) JMU Center of Excellence, Cardiovascular Research and Development (JCARD) Hypertension Cardiovascular Outcome Prevention and Evidence in Asia (HOPE Asia) Network Shimotsuke, Tochigi, 329-0498, JAPAN MedicalResearch.com: What is the background for this study? Response: To date, it remains unclear whether disrupted blood pressure (BP) circadian rhythm is associated with adverse outcomes independent of nighttime BP. The JAMP study includes 6359 outpatient population who had ambulatory BP monitoring to evaluate the association between both nocturnal hypertension and nighttime BP dipping patterns and the occurrence of cardiovascular events in patients with hypertension. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, NYU, Race/Ethnic Diversity / 16.09.2020

MedicalResearch.com Interview with: Aisha T. Langford, PhD, MPH Assistant Professor Department of Population Health Co-Director, CTSI Recruitment and Retention Core NYU Grossman School of Medicine NYU Langone Health New York, NY 10016 MedicalResearch.com: What is the background for this study? Response: In 2018, the American Heart Association (AHA) published an updated Scientific Statement on Resistant Hypertension. The term apparent treatment-resistant hypertension (aTRH) is used when pseudoresistance (e.g., white coat effect, medication nonadherence) cannot be excluded. The current study was designed to investigate if Black adults with aTRH, a group disproportionately affected by cardiovascular disease, receive evidence-based approaches to lower blood pressure as recommended in the 2018 AHA Scientific Statement. Specifically, we studied healthy lifestyle factors including not smoking, not consuming alcohol, ≥75 minutes of vigorous-intensity or ≥150 minutes of moderate or vigorous physical activity per week, and body mass index <25 kg/m2; and recommended antihypertensive medication classes among US Black adults. (more…)
Author Interviews, Blood Pressure - Hypertension, Social Issues / 01.08.2020

MedicalResearch.com Interview with: Dr. Shingo Yanagiya Hokkaido University Graduate School of Medicine Sapporo, Japan MedicalResearch.com: What is the background for this study? Response: Thank you very much for your question. Hypertension is a major risk factor for cardiovascular diseases including stroke and ischemic heart disease. Due to the relatively high prevalence of hypertension, there is an increased public burden resulting mainly from cardiovascular disease. It is well known that hypertension is associated with several lifestyle factors, including excessive intake of salt or alcohol, obesity, inactivity, and other personal attributes. Since socioeconomic status affects individual lifestyles and other factors, differences in socioeconomic status may influence the risk of hypertension. Therefore, it is important to clarify whether the risk of hypertension varies among socioeconomic classes when considering an effective strategy for preventing hypertension. Based on my research of previous reports about the relationship between household income and incident hypertension, evidence is scarce for Japan. So, we investigated this in an employed population in Japan. (more…)
Author Interviews, Blood Pressure - Hypertension, UT Southwestern / 15.04.2020

MedicalResearch.com Interview with: DaiWai Olson, PhD, RN Professor of Neurology and Neurotheraputics UT Southwestern Medical Center MedicalResearch.com: What is the background for this study? Response: This study resonates across nursing. Kat Siaron is a Neuroscience nurse who had questions about the ‘best’ location for checking blood pressure. Like so many studies this started with a clinical question: “does it make a difference where you check the blood pressure?” She applied for a nursing research fellowship and was one of 6 nurses selected. She spent about 3 months reading articles on blood pressure and looking to see if there are any similar studies. After confirming that this has not been done, she submitted her study for approval from the Institutional Review Board and started data collection. (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease, Weight Research / 08.04.2020

MedicalResearch.com Interview with: Zhen Yang MD PhD Department of Endocrinology, Xinhua Hospital Shanghai Jiao Tong University School of Medicine Shanghai, China   MedicalResearch.com: What is the background for this study? Response: Hypertension is a major public health problem affecting more than 1 billion people worldwide. And it is the leading cause of mortality and disability globally. Startlingly, more than half of people with elevated blood pressure were unaware of their hypertensive status in numerous surveys, partly owing to hypertension rarely shows symptoms in the early stages. Hence, hypertension is a silent killer. (more…)
Author Interviews, Blood Pressure - Hypertension, Columbia, Heart Disease, JAMA / 17.02.2020

MedicalResearch.com Interview with: George Hripcsak, MD, MS Vivian Beaumont Allen Professor of Biomedical Informatics Chair, Department of Biomedical Informatics Columbia University Director, Medical Informatics Services NewYork-Presbyterian Hospital/Columbia MedicalResearch.com: What is the background for this study? Response: Diuretics are considered among the best drugs to treat hypertension, but there are no randomized studies to tell us which diuretic is best. Hydrochlorothiazide is the most frequently used diuretic for hypertension, but another drug, chlorthalidone, is gaining favor, with the most recent US hypertension guideline expressing a preference for it. Chlorthalidone is known to be longer acting and therefore perhaps more effective. Other (non-randomized) studies have been inconsistent, and some of them imply that chlorthalidone may be more effective. But other studies have shown that chlorthalidone may have more side effects. (more…)
Author Interviews, Blood Pressure - Hypertension, Brigham & Women's - Harvard, Gout / 28.01.2020

MedicalResearch.com Interview with: Stephen P. Juraschek, MD, PhD Assistant Professor, Harvard Medical School Beth Israel Deaconess Medical Center Division of General Medicine, Section for Research Boston, MA  02215 MedicalResearch.com: What is the background for this study? Response: Gout is a common complication of blood pressure treatment. Furthermore, 75% of adults with gout have hypertension. There are several classes of medications uses to treat hypertension. While prior studies have reported that calcium channel blockers like amlodipine lower uric acid, its effects on gout risk compared to other common first-line antihypertensive agents are unknown.  (more…)
Author Interviews, Blood Pressure - Hypertension, JAMA / 26.11.2019

MedicalResearch.com Interview with: Brian S. Alper, MD, MSPH, FAAFP, FAMIA Board Certifications: Family Medicine, Clinical Informatics Founder of DynaMed Vice President of Innovations and Evidence-Based Medicine Development EBSCO Health  MedicalResearch.com: What is the background for this study? Response: We often use clinical practice guidelines as a “source of truth” for decision support for healthcare professionals and even as a standard of care for medical legal considerations.  However our experience evaluating guidelines for clinical reference support finds they are often inconsistent.  We picked one of the most common conditions managed in healthcare (ie hypertension, or high blood pressure) and sought out the top clinical practice guidelines that guide care around the world.   We systematically evaluated these guidelines against 70 specific recommendations to see how often the guidelines agreed or disagreed. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Heart Disease / 05.11.2019

MedicalResearch.com Interview with: Rachel E. Climie PhD INSERM U970, Paris Cardiovascular Research Center (PARCC) Integrative Epidemiology of Cardiovascular Disease Team, University de Paris, Paris, France.  MedicalResearch.com: What is the background for this study? Response: It is well known that physical activity (PA) is beneficial for cardiovascular health. However, little consideration is given as to whether different domains of PA have differing associations with health outcomes. Indeed, recent work has shown that high amounts of PA at work are associated with increased risk of early death, however the underlying mechanisms are unknown. In this study, we explored the relationship between physical activity at work, during leisure time and as structured sport with baroreflex sensitivity. We distinguished between the mechanical (dependent on the stiffness of the arterial wall) and neural (nerve impulses sent by the receptors on the walls of the artery) components of the baroreflex. Importantly, baroreflex sensitivity is crucial for short- term blood pressure control and reduced baroreflex function is related to higher risk of cardiac mortality and sudden death.  (more…)
Author Interviews, Blood Pressure - Hypertension, Obstructive Sleep Apnea / 13.09.2019

MedicalResearch.com Interview with: Mireia Dalmases Cleries, MD Hospital Universitari Arnau de Vilanova and Santa Maria Group of Translational Research in Respiratory Medicine Lleida, Cataluña, Spain MedicalResearch.com: What is the background for this study? Response: Obstructive sleep apnea has been associated with poor blood pressure control and resistant hypertension. Moreover, it has been described that its treatment with continuous positive pressure (CPAP) could be an effective means of controlling blood pressure in this population. Nevertheless, studies assessing OSA prevalence, characteristics and association with blood pressure control in resistant hypertensive patients are limited and that’s the reason why we decided to perform this study. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, University of Pennsylvania / 09.09.2019

MedicalResearch.com Interview with: Jordana Cohen, MD, MSCE Assistant Professor of Medicine and Epidemiology Renal-Electrolyte and Hypertension Division Center for Clinical Epidemiology and Biostatistics Perelman School of Medicine University of Pennsylvania MedicalResearch.com: What is the background for this study? Response: In the June 18, 2019 issue of Annals of Internal Medicine, we published a systematic review and meta-analysis evaluating the cardiovascular risks of white coat hypertension (WCH; i.e. elevated office blood pressure and normal out-of-office blood pressure). The goal of the meta-analysis was to clarify previous mixed results regarding the risks of untreated WCH and treated WCH. The meta-analysis examined 27 studies – including 64,273 patients – and demonstrated that untreated WCH is associated with an increased risk of cardiovascular events (36%), all-cause mortality (33%), and cardiovascular mortality (109%) compared to normotension. This risk was strongest in studies with a mean age ≥55 years or that included participants with cardiac risk factors, such as diabetes and chronic kidney disease. We found no increased cardiovascular risk associated with treated white coat hypertension. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Technology / 07.08.2019

MedicalResearch.com Interview with: Kang Lee, PhD Dr Eric Jackman Institute of Child Study University of Toronto Toronto, Canada MedicalResearch.com: What is the background for this study? Response: We use a technology called transdermal optical imaging I and my postdoc invented to record facial blood flow using a regular video camera on the smartphone. This technology capitalizes on the fact that light travels beneath the facial skin and reflect off the hemoglobin under the skin. Our technology captures the minute reflected photons to decode facial blood changes due to our pulses and other physiological activities. Using machine learning, a neural network model learns to use the facial blood flow to predict blood pressures taken with a FDA approved scientific blood pressure measurement instrument. We then use the final model to predict the blood pressures of a new group of participants whose data had never been used in the model training. (more…)